Initial clinical experience with the Heartstring

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Aortic Procedures

Background:

• Proximal anastomosis traditionally requires aortic clamping.
• The Heartstring device offers an alternative for aortic anastomosis without clamping.
• Its application in both low-risk and high-risk patients warrants investigation.

Purpose of the Study:

• To evaluate the initial outcomes of using the Heartstring device for proximal anastomosis.
• To assess the safety and efficacy of the Heartstring in diverse patient populations, including those with diseased aortas.

Main Methods:

• The Heartstring device was used in 87 patients (62 men, 25 women; age 48-86) between January and December 2004.
• Preoperative assessment included computed tomography (CT) scanning and epiaortic echocardiography for aortic calcification grading.
• Patient risk was evaluated using the EuroSCORE, with postoperative angiography performed on day three.

Main Results:

• CT scans showed no or varying degrees of calcification in the ascending aorta of 87 patients.
• A total of 93 proximal and 149 distal anastomoses were performed, with 74.2% of distal anastomoses targeting the circumflex artery territory.
• Postoperative coronary angiography confirmed all grafts were patent, indicating successful revascularization.

Conclusions:

• The Heartstring device facilitates safe proximal anastomosis, even in high-risk patients with diseased aortas.
• Initial short-term outcomes were favorable, demonstrating the device's efficacy.
• The device aids in bypassing the circumflex artery territory, though long-term follow-up is recommended.